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Flashcards in Resp Deck (45):
1

What is pulmonary ventilation rate?

resp rate x tidal volume

2

what is vapour pressure? What is saturated vapour pressure dependent on?

vapour pressure - pp of water above a surface of water
dependent on temp

3

what is tension

gases tendency to escape a liquid

4

Which ribs are typical and which are true ribs?

3-9 typical
1-7 true

5

describe the appearance of ribs 1 and 2

1 - shorter and wider with groove for subclavian artery. oonly 1 articular facet
2 - rough area for attachment of serratus anterior

6

What is the costal margin?

upside down V formed by cartilage of ribs 7 - 10

7

What is the direction of fibres of the external and internal intercostals?

external - anterior and inferior (hands in pocket)
internal - anterior and superior

8

What do the intercostal veins drain into?

azygous vein

9

what can be found in the superior mediastinum? What is its superior and inferior boundary

arch of aorta, trachea, oesophagus, SVC, phrenic nerve

Boundary - thoracic inlet to T4

10

What can be found in the anterior mediastinum?

thymus in kids, long thoracic artery and vein

11

Posterior mediastinum?

oesophagus, thoracic aorta, azygous vein, vagus nerve

12

What is the nitrogen washout used for and how does it owrk?

used to measure serial dead space.
forced expiration then inspire 100% o2 and measure n2 released in expiration

13

Is asthma obstructive or restrictive?

obstructive

14

what does helium dilution measure and how does it work?

measures residual volume. Helium doesnt enter blood, measure difference in conc.

15

What gas molecule is used to measure transfer conductance/

CO

16

How does haem buffering prevent fluctuations in pH?

increase in co2 results in addition of H+ to form HCO3
Decrease in co2 results in addition of water to form H+

17

what are the effects of acidosis and alkalosis?

acidosis - seizures, arrhythmia, vomiting
alkalosis - fainting, tetany

18

Where are the central chemoceptors found? How does blood pH affect the central chemoceptors?

medulla
co2 can enter but hco3 cant

19

what does chronic hypoxia result in?

pulmonary hypertension

20

what are the symptoms of asthma?

polyphonic wheeze, SOB, dry cough, chest tightness

21

how would you investigate asthma?

flow volume loop (obstructive) with a 12% increase in FEV with salbutamol, FENO (NO exhaled in inflammation)

22

What are the symptoms of COPD?

hypercapnia (flapping), tachypnoea, accessory muscle usage

23

what are the resp defences?

mucociliary escalator, cough and sneeze, macrophages, IgA and IgG

24

how do you treat hospital and community acquired pneumonia?

hosp - co-amoxiclav
community - penicillin

25

What are the common MOs that cause hosp and community pneumonia

hosp - MRSA, staph aureus, pseudomonas aeruginosia
community - strep pneumoniae, klebsiella pneumoniae, H.influenzae

26

What are the symptoms of pneumonia?

productive cough, dyspnoea, inspiratory chest pain, vomiting, fever, dull percussion, wheezes crackles and bronchial breathing on auscultation

27

How do you assess the severity of pneumonia?

CURB 65
U - >7 mmol
R - >30
BP - less than 90/60
over 65

28

How can bronchial breath sounds be pathological?

if heard outside of trachea, indicates consolidation.

29

How does clavulinic acid work?

suicide inhibitor of beta lacatamase

30

Outline the pathophysiology of TB

primary - subpleural granuloma with granulomatous hilar lymph node infection

31

What is the host reponse to TB?

macrophase ingestion. TB escapes and multiplies in cytoplasm. granuloma forms.

32

What are the symptoms of TB?

sputum, haemoptysis, fever, weight loss

33

How do you treat TB?

RIPE - RIPE for 2 months and then RI for another 4 months
Rifampicin
Isoniazide
Pirazinimide
Ethambutol

34

What symptom suggests regional metastases of a lung cancer?

hoarsenss of voice

35

What are the common lung cancer types/

squamous cell, adenocarcinoma, large cell, small cell

36

what does pleural effusion look like on a CXR?

loss of costophrenic angles, meniscus

37

What are the symptoms of ILS?

SOB, dry cough, tachypnoea, tachycardia, coarse crackles, cyanosis, RHF, restrictive

38

What factors result in an increase in pleural fluid?

increased BP, increased permeability (infection or malignancy), decreased oncotic

39

What factors results in decreaed reabsorption?

increased BP, lymph blockage

40

define transudate

30g protein per litre or less

41

What are the symptoms of PE?

SOB, chest pain on inspiration, cyanosis, tachycardia, haemoptysis

42

How do you diagnose PE

d-dimer to exclude in those with low probability, CT pulmonary angiogram

43

how do you treat PE?

heparin/warfarin

44

What are the symptoms of pleurisy?

pleural rub, pain on inspiration, cough, sneeze, shoulder pain (referred)

45

What is pleurisy caused by?

RA, SLE, infection, cancer, PE